What is the recommended vaccination schedule for Inactivated Poliovirus Vaccine (IPV)?

Recommended Vaccination Schedule for Inactivated Poliovirus Vaccine (IPV)

All children should receive four doses of IPV at ages 2 months, 4 months, 6-18 months, and 4-6 years, with the final dose administered at age ≥4 years regardless of the number of previous doses. 1

Standard IPV Vaccination Schedule

The Advisory Committee on Immunization Practices (ACIP) recommends the following schedule for routine childhood polio vaccination in the United States:

• Primary series:
  • First dose: 2 months of age
  • Second dose: 4 months of age
  • Third dose: 6-18 months of age
• Booster dose:
  • Fourth dose: 4-6 years of age 2, 1

Important Intervals Between Doses

• Minimum interval between doses 1 and 2: 4 weeks
• Minimum interval between doses 2 and 3: 4 weeks
• Minimum interval between doses 3 and 4: 6 months 2

The minimum age for the first dose is 6 weeks. However, using minimum intervals and minimum ages in the first 6 months of life is recommended only if the vaccine recipient is at risk for imminent exposure to circulating poliovirus (e.g., during an outbreak or travel to a polio-endemic region). This precaution exists because shorter intervals and earlier start dates lead to lower seroconversion rates. 2

Special Considerations with Combination Vaccines

When DTaP-IPV/Hib (Pentacel) is used to provide 4 doses at ages 2,4,6, and 15-18 months, an additional booster dose of age-appropriate IPV-containing vaccine should be administered at age 4-6 years. This will result in a 5-dose IPV vaccine series, which is considered acceptable by ACIP. 2, 1

Vaccination for Adults

• Adults who have previously completed a primary series and are at increased risk for poliovirus exposure should receive a single booster dose of IPV. 1
• For unvaccinated adults at increased risk, a primary vaccination series with IPV is recommended:
  • Two doses at 4-8 week intervals
  • Third dose 6-12 months after the second dose 2
• If accelerated protection is needed:
  • If >8 weeks available: Three doses at least 4 weeks apart
  • If 4-8 weeks available: Two doses at least 4 weeks apart
  • If <4 weeks available: Single dose of IPV 2

High-Risk Groups Who Should Receive IPV

• Travelers to areas where polio is endemic or epidemic
• Members of communities with active poliovirus circulation
• Laboratory workers handling specimens that might contain polioviruses
• Healthcare workers in contact with patients who might be excreting wild polioviruses 2, 1

Contraindications and Precautions

• IPV should not be administered to persons with severe allergic reactions to previous IPV doses or to antibiotics contained in IPV (streptomycin, polymyxin B, neomycin) 2, 1
• Pregnancy: Vaccination should be avoided unless the woman is at increased risk and requires immediate protection 1
• IPV should NEVER be administered intravenously 1

Effectiveness and Safety

IPV is highly effective at preventing paralytic poliomyelitis. The transition from oral poliovirus vaccine (OPV) to IPV in the United States was implemented to eliminate the risk of vaccine-associated paralytic poliomyelitis (VAPP) that was associated with OPV use 2. Studies have shown that IPV provides excellent protection against paralysis through the presence of circulating antibodies that neutralize virus infectivity toward motor neurons 3.

The safety profile of IPV is excellent, with no serious adverse events documented related to the use of enhanced-potency IPV 2. This safety profile, combined with its effectiveness, makes IPV the vaccine of choice for protection against paralytic poliomyelitis in settings where high vaccination coverage can be maintained 4.